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Biomedical subjects

Chiho Obayashi

Publications and source records attributed to Chiho Obayashi.

7 recordsLinked to original sources

Lung carcinosarcoma with liposarcoma element: autopsy case.

Pulmonary carcinosarcoma, consisting of both carcinoma and sarcoma with a heterologous element, is a rare subtype, comprising approximately 0.3% of primary lung neoplasia. A 57-year-old man was admitted because of severe dyspnea. A tumor wholly occupying the right thorax was biopsied and diagnosed as pleomorphic sarcoma. The tumor did not respond to chemotherapy, and the patient died of respiratory failure and sepsis. At autopsy, pleomorphic sarcoma was histologically dominant and contained a liposarcoma element confirmed by histocytological and electron microscopic analysis. Adenocarcinoma component with papillary and tubular patterns was confined to the medial lesion of the right lower lobe (3x8 cm), which was found in the chest X-ray 3 years before admission, and had continuously merged with the sarcomatous lesion through the histological transition of both components. Aggressive and rapid growth of the sarcoma derived from the earlier adenocarcinoma became prevalent and contributed to the severe clinical outcome. This is the first documented case of primary lung carcinosarcoma with a liposarcoma element.

Antineoplastic Combined Chemotherapy Protocols↗

Desmoid tumor with ossification in chest wall: possible involvement of BAMBI promoter hypermethylation in metaplastic bone formation.

UNLABELLED: A rare case of desmoid-type fibromatosis with focal metaplastic bone in the chest wall suggested that enhanced responsiveness to BMP signaling by decreasing BAMBI expression through promoter hypermethylation plays a crucial role in the formation of metaplastic bone. INTRODUCTION: Desmoid-type fibromatosis, originating from mesenchymal cells with myofibroblastic features, is a locally aggressive and frequently recurring infiltrative lesion. One such sporadic case with metaplastic ossification in the chest wall is presented. MATERIALS AND METHODS: A 43-year-old man was referred to the hospital with a gradually enlarging hard mass in the left anterolateral chest wall. A thoracotomy was carried out, and histopathological specimens were used for immunohistochemical, genetic, and methylation studies. RESULTS: Accumulation of altered beta-catenin associated with a somatic heterozygous activating mutation in codon 41 was detected in the typical desmoid-type fibromatosis and at the ossifying focus. Among factors related to bone formation and the classical wnt-beta-catenin signaling pathway, BMP and activin membrane-bound inhibitor (BAMBI) expression was specifically downregulated at the ossifying focus. Hypermethylation of the BAMBI promoter was observed in microdissected tissue from the ossifying focus but not in that from the typical desmoid-type fibromatosis. CONCLUSIONS: Because both BMP and classical Wnt/beta-catenin/LEF1 signaling cooperatively and mutually induce differentiation of mesenchymal cells into osteoblastic cells and promote bone formation, the epigenetic event leading to the enhanced responsiveness to BMP signaling may play a crucial role in the formation of metaplastic bone.

Adult↗

Coexisting Brenner tumor and struma ovarii in the right ovary: case report and review of the literature.

A bilateral ovarian tumor composed of mixed Brenner tumor and struma ovarii in the right ovary and mature cystic teratoma in the left ovary, is described. Mixed Brenner tumor and struma ovarii is rare; eight cases are reviewed. In this case, in addition to the typical Brenner tumor and struma ovarii, some nests composed of both Brenner tumor and struma ovarii in one nest were found in the right ovarian tumor. Immunohistochemically, the struma ovarii is stained for thyroglobulin, and Brenner nests showed various degrees of positive stain for thyroglobulin, which is a specific finding. Brenner tumor, in this case, may produce thyroglobulin or have a receptor to thyroglobulin or analog of thyroglobulin. The origin of mixed Brenner tumor and struma ovarii may be germ cell, as described in some literature, or the Brenner tumor may be of a metaplastic nature, although the Brenner tumor is fourfold the size of struma ovarii in the case presented.

Adult↗

Central poorly differentiated adenocarcinoma of the maxilla: report of a case.

Central adenocarcinoma of the jaws is an extremely rare malignant tumor. We reported a case of poorly differentiated adenocarcinoma occurring intraosseously in the maxilla. A 62-year-old male was referred to our hospital because of swelling of the palate. MRI showed a central tumorous lesion in the maxilla. He underwent maxillectomy combined with neck and parapharyngeal dissection. Histologic examinations of the surgical specimen revealed poorly differentiated adenocaricinoma showing a positive reaction for PAS, CEA and cytokeratin. He underwent adjuvant chemotherapy with cis-platinum diamminodichloride, 5-fluorouracil, and pirarubicin, but he died of multiple distant metastases 7 months after the surgery.

Adenocarcinoma↗

[Clinical evaluation of mediastinal hematologic malignancies (lymphoma and granulocytic sarcoma)].

In a retrospective review of all patients who visited our hospital between January 1997 and December 2001, we identified 22 with mediastinal lymphoma or mediastina granulocytic sarcoma. They represented 24.2% of the 91 patients with mediastinal tumors. Histology revealed 6 cases of diffuse large B-cell lymphoma, 6 of lymphoblastic lymphoma, 6 of Hodgkin's disease, 2 of granulocytic sarcoma, and 1 of lymphoplasmacytic lymphoma. More than 1/3 of the tumors had highly aggressive histological pictures. Immunocytochemical analysis of cell surface markers by flow cytometry was very useful for reaching a definitive diagnosis of these tumors. In two cases, definitive diagnosis could be obtained only by flow cytometric examination of pleural or pericardial effusion. Careful attention should be paid to the relatively high incidence of hematologic malignancies in mediastinal tumors. Early and accurate diagnosis of these tumors is essential because some of these patients require immediate treatment by hematology specialists.

Adolescent↗

[Invasive pulmonary aspergillosis complicated by complete atrioventricular block and aspergillus pericarditis after induction chemotherapy in a patient with acute lymphoblastic leukemia].

A 50-year-old man developed invasive pulmonary aspergillosis after induction chemotherapy for acute lymphoblastic leukemia. He was treated with 5-fluorocytosine and intravenous amphotericin B (AMPH-B). During antifungal therapy, he developed aspergillus pericarditis and complete atrioventricular (A-V) block. The pericardial effusion was decreased and the A-V block was improved after treatment with intravenous and intrapericardial instillation of AMPH-B. Because the patient's renal function deteriorated, AMPH-B was replaced with itraconazol after the latex agglutination (LA) test for an aspergillus-specific antigen showed a negative result. The patient, however, died from disseminated aspergillosis. Aspergillus DNA was detected in retrospective analysis of the serum which had been negative with the LA test. This case indicates that LA is not sufficient for diagnosis and post therapy evaluation of invasive aspergillosis. PCR or other methods should be used concomitantly with LA. Intrapericardial instillation of AMPH-B might be effective for patients with aspergillus pericarditis in whom surgical treatment is not indicated.

Aortic Valve Insufficiency↗

[A case of follicular lymphoma derived from the conjunctiva].

BACKGROUND: Follicular lymphoma, derived from ocular adnexa as defined by World Health Organization Classification of neoplastic diseases of the hematopoietic and lymphoid tissues, is quite rare in Japan. CASE: A 65-year-old woman visited our clinic for treatment of a conjunctival tumor in the left eye. FINDINGS: Incisional biopsy revealed that the lesion was a lymphoma with well-defined follicles, and it was L 26(CD20) and BCL-2 positive immunohistochemically. Flow cytometric analysis showed that more than 70% of the cells were double positive for CD10 and CD20. Southern blot hybridization demonstrated gene rearrangement bands in the immunoglobulin gene JH region. The chromosome had a translocation t(14, 18) (q32, q21). Systemic evaluation detected no other lymphoma. CONCLUSION: The lesion was a follicular lymphoma derived from conjunctival tissue. Additional examinations such as flow cytometric analysis, gene analysis, and chromosome examination were useful for differential diagnosis of marginal zone B cell lymphoma of mucosa associated lymphoid tissue type and benign reactive lymphoid hyperplasia.

Aged↗